Fertility treatment bans in Europe raise controversy, questions

The world’s first test-tube baby was born more than three decades ago in Britain. But today, many people who need help having a child still face restrictions on fertility treatments.

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Many European countries have strict rules on who is allowed to get fertility treatments: France and Italy forbid single women and lesbian couples from using artificial insemination and in vitro fertilization, or IVF, to conceive. Austria and Italy are among those banning all egg and sperm donations for IVF. Germany and Norway ban donating eggs, but not sperm. In Sweden, couples must be in a stable relationship for at least a year before qualifying for fertility treatment. And nearly everywhere in Europe except Ukraine, couples are banned from hiring a woman to carry a pregnancy for them.

The European laws stand in contrast to comparatively few restrictions elsewhere, including in the U.S., Australia, Brazil and Canada.

What do experts have to say about the various restrictions? “These laws are completely out of date,” Dr. Francoise Shenfield, a fertility expert at University College London, said. “It’s a medical treatment and the decision to treat should be up to doctors.”

Shenfield said placing bans on egg and sperm donation is “discriminating against infertile couples,” although she acknowledged that there are valid medical reasons for not treating some patients, like women over 50.

Marie Eriksson, a 36-year-old single mother in Sweden, described the restrictions as prejudice. “Having a child is not a right, but the possibility should not be forbidden because you don’t have a partner,” she said.

Eriksson, a librarian, traveled to a fertility clinic in Denmark after deciding she wanted to have a child on her own. “The alternative was to go out and meet a stranger at a pub,” she said.

Experts estimate thousands of Europeans travel to another country each year for help having a baby, though exact figures aren’t recorded.

Why are there so many restrictions? Reasons vary from country to country. Many cite concerns about creating “unnatural” relationships between donors, parents and children. Others are driven by religious or cultural objections.

For gay and lesbian couples in France, Italy, Switzerland and elsewhere, only one partner can be the child’s legal father or mother.

“These restrictions imply that gays and lesbians are second-class citizens and that a child has to be raised in a conventional family,” said Angelo Berbotto, a lawyer and acting secretary of NELFA, Europe’s largest organization for gay and lesbian families.

For IVF, women undergo hormone stimulation to produce eggs and a procedure to extract them from the ovaries. Embryos are created by mixing sperm and eggs together in a lab, then transferred into a woman’s womb.

In Italy, a law supported by leading Catholic groups clamped down on egg and sperm donation in 2004, based on concerns that embryos may be killed in the process. The law restricts IVF to “stable, heterosexual couples who live together and are of childbearing age.” Italy says allowing donated eggs could exploit women and that the practice “would lead to a weakening of the entire structure of society.”

Most couples seeking fertility treatments don’t need donated eggs and sperm. And many government health systems will pay for fertility treatments for those who have been trying at least three years to conceive.

“I’m often dumbfounded by the position some European countries take on IVF,” said Dr. Norbert Gleicher, medical director of the Center for Human Reproduction, a private clinic in New York City.

The restrictions in many European countries would be unthinkable in the U.S., Gleicher said, adding about 40 percent of his patients travel from abroad, many from Europe.

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